Flatter stools
January 21, 2024 5:50 AM Subscribe
Good morning
I am posting here because I have horrible medical anxiety. I am scheduled to have a colonoscopy in 1 week. I always had normal stools, then recently stopped Mounjaro and I took Doxycycline for an upper respiratory infection. Immediately like overnight 2 weeks ago I developed constipation. Now I have thinner stools ( flatter and this morning I had at the end a pencil shaped one- mix of flat with pencil shaped) I also have hemorrhoids so one day they were acting up. I decided to do a IFOBT which was positive
I am so worried for colon cancer. I am 36 without hx of colon cancer or family hx ( grandpa had CRC but diagnosed at 86)
I had a rectosigmoidoscopy at age 33.5 which was normal- didn’t find any polyps at all
I am basically a wreck. Anyone else experienced these abnormal pencil shaped stools and what did ended up being?
I think I will be a wreck ball until 1/29 when my colonoscopy is scheduled
Stop looking at your poop. When you have a BM, flush the toilet before you stand up. There is no value, only harm, in further examinations like this. You should instead focus on whatever it is you need to do over the next week to calm your anxiety. Walks, talking with family/friends, medication if that has worked for you in the past, etc.
posted by scantee at 6:27 AM on January 21 [5 favorites]
posted by scantee at 6:27 AM on January 21 [5 favorites]
Stools get squished round the side of other, more constipated stools. Hope it resolves for you soon.
posted by lokta at 6:39 AM on January 21 [3 favorites]
posted by lokta at 6:39 AM on January 21 [3 favorites]
The very, very most likely explanation here, given your age, recent antibiotic use, recent sigmoidoscopy and lack of family history is that your digestion is still off. Colon cancer is usually a slow-moving cancer, which is why screenings are scheduled every ten years. It is unlikely that you could have had a normal sigmoidoscopy 2.5 years about and now have serious enough colon cancer to produce this symptom.
I was reading up on this before a recent colonoscopy and some doctors feel that it is mistaken to tell people that narrow stools mean colon cancer - it's not common as an early sign at all.
Unfortunately, speaking as someone who suffered terribly from health anxiety in my twenties and thirties, no one can really promise you that you will 100% be okay, but much the most likely explanation here is that your digestion is borked from the antibiotic.
If you routinely go through bouts of health anxiety, I strongly suggest going to therapy. I did talk therapy for a while for Various Bad Past Experiences, and it turned out that the emotional force of the health anxiety was actually the Bad Past, and once I felt better about the past, the health anxiety diminished by probably 80%.
Also, one time in my thirties, I was sure I had ALS, because I had so much muscle twitching everywhere - it was just horrible, I did not control it, it went on for months. I spent a lot of time on the internet. I had a full medical work up. Actually I did not have ALS, and in fact if I had not been so anxious/depressed, I would have realized that my symptom profile didn't fit ALS - I definitely had the twitches, I suspect that a combination of viral illness and anxiety caused them and they took some years to go away for good, but the answer was in fact "the most likely medical explanation is correct" not "the worst case scenario that your symptoms do not match".
posted by Frowner at 6:41 AM on January 21 [8 favorites]
I was reading up on this before a recent colonoscopy and some doctors feel that it is mistaken to tell people that narrow stools mean colon cancer - it's not common as an early sign at all.
Unfortunately, speaking as someone who suffered terribly from health anxiety in my twenties and thirties, no one can really promise you that you will 100% be okay, but much the most likely explanation here is that your digestion is borked from the antibiotic.
If you routinely go through bouts of health anxiety, I strongly suggest going to therapy. I did talk therapy for a while for Various Bad Past Experiences, and it turned out that the emotional force of the health anxiety was actually the Bad Past, and once I felt better about the past, the health anxiety diminished by probably 80%.
Also, one time in my thirties, I was sure I had ALS, because I had so much muscle twitching everywhere - it was just horrible, I did not control it, it went on for months. I spent a lot of time on the internet. I had a full medical work up. Actually I did not have ALS, and in fact if I had not been so anxious/depressed, I would have realized that my symptom profile didn't fit ALS - I definitely had the twitches, I suspect that a combination of viral illness and anxiety caused them and they took some years to go away for good, but the answer was in fact "the most likely medical explanation is correct" not "the worst case scenario that your symptoms do not match".
posted by Frowner at 6:41 AM on January 21 [8 favorites]
If it helps as reassurance at all, I think the presence of hemorrhoids is a perfectly valid explanation for blood in the stool? And as someone else mentioned, constipation can cause thin stools just because of the traffic jam situation and newer stool trying to get around stuck stool.
As a hopefully reassuring datapoint I know someone who was terrified she would be diagnosed with cancer during a colonoscopy because of frequent experiences of lots of visible blood in the bowl -- not only was it just hemorrhoids and polyps, but they were able to remove and fix them during the examination and she felt way better afterward.
posted by space snail at 7:14 AM on January 21
As a hopefully reassuring datapoint I know someone who was terrified she would be diagnosed with cancer during a colonoscopy because of frequent experiences of lots of visible blood in the bowl -- not only was it just hemorrhoids and polyps, but they were able to remove and fix them during the examination and she felt way better afterward.
posted by space snail at 7:14 AM on January 21
Hey, in 2020 I did a IFOBT in lieu of a colonoscopy as a means of avoiding potential exposure to covid. The result of the IFOBT was positive. Scared the crap out of me (excuse the poor humor). So I went ahead and had a colonoscopy. Turns out the IFOBT was positive not because of cancer, but because of a damn hemorrhoid that has never given me any trouble whatsoever and that I've never even been able to tell I have. Now, every time an IFOBT commercial comes on TV I give it the finger.
posted by SageTrail at 7:15 AM on January 21 [3 favorites]
posted by SageTrail at 7:15 AM on January 21 [3 favorites]
You will get your answer in a week. Whatever you've got or don't got, that situation already exists. There is nothing you can do, no championship-grade amount of freaking out you can do for the next week, that will make cancer go away if you have it or give you cancer if you don't.
Stop looking. Flush behind you, you know where the handle is without turning around. Or close the lid behind you before you turn to flush. If there was any week you're exempted from obsessing about your feces, the week before a scope is it.
You probably don't have cancer. If you do have cancer you will treat it. That is the answer to the anxiety question "what if I have cancer???????" If you have cancer you will treat it. If you don't have cancer you will do all the recommended stuff shown to prevent it, including treating your anxiety.
posted by Lyn Never at 7:23 AM on January 21 [5 favorites]
Stop looking. Flush behind you, you know where the handle is without turning around. Or close the lid behind you before you turn to flush. If there was any week you're exempted from obsessing about your feces, the week before a scope is it.
You probably don't have cancer. If you do have cancer you will treat it. That is the answer to the anxiety question "what if I have cancer???????" If you have cancer you will treat it. If you don't have cancer you will do all the recommended stuff shown to prevent it, including treating your anxiety.
posted by Lyn Never at 7:23 AM on January 21 [5 favorites]
Doxycycline also gave me weird poop - that really seems the most likely cause. I agree with the advice to stop looking/analyzing your stools.
posted by coffeecat at 7:44 AM on January 21 [2 favorites]
posted by coffeecat at 7:44 AM on January 21 [2 favorites]
Medical anxiety is so difficult! When I go for a run of the mill yearly checkup with no indications of illness my blood pressure skyrockets to 150/110. When I measure it at home, the more I measure the more my bp increases, because at this point it’s the act of observation that triggers the anxiety! Anyway I’m sharing this to tell you that you are not alone.
Unlike you I do have an extremely prevalent history of colon cancer - my father and brother have both had cancerous polyps removed in the past few years, my uncle and grandfather and great grandmother all died from it, etc. I have not yet had a colonoscopy and despite my family history have no been able to get one scheduled until this year, when I turn forty. Isn’t that absurd? So, first of all, CONGRATULATIONS, you are doing the single most effective thing you can do to prevent colon cancer, years ahead of most people with strong risk factors. But also, again, you are already doing the most effective thing you can do. You probably have all this anxious energy and no where to put it while you wait.
My recommendation to you is to first try your absolutely damnedest to stop looking in the toilet bowl. If you fail at first that’s okay, just try again next time. Invest in a peri bottle to help keep yourself clean with much less irritation from lots of toilet paper friction if you don’t have a bidet already. If you have an external fissure or hemorrhoid flushing it with water will help it heal, too. I love using mine when I’m menstruating. It’s marketed as a portable thing but I just keep mine next to my tub for easy filling at home. Other than being gentle to your butt like this try to avoid ruminating on the area or anything that comes out of it. I know that’s difficult! But keep trying to redirect yourself.
My second suggestion is to get some physical activity. Depending on what you’ve been doing lately, just increase or vary it a small amount. So if you are normally athletic and training for a marathon or whatever, try some different activities that use different movements so you are engaging more of your mind and body in them, like martial arts or tennis. And if you’re like me a complete couch potato, try leaving some small weights around where you hang out, or dance in your kitchen, or go for a walk one day and do half an hour of yoga the next. Anything to take that anxious energy and use it up! Added benefits of this are that increased activity helps constipation and can be part of maintaining regularity of bowel movements. When I’m especially freaking out, a series of standing jacks, bodyweight squats, and fast paced sun salutations can really help me. It takes all that freakout juice and pushes it out through my breathing and sweat. Try to find your own thing that is super low barrier for you, so probably nothing that requires special equipment or locations, that you can just start doing when you feel your anxiety filling your body.
Good luck! You can get through this time period and you are doing exactly the right thing for now.
posted by Mizu at 8:05 AM on January 21 [4 favorites]
Unlike you I do have an extremely prevalent history of colon cancer - my father and brother have both had cancerous polyps removed in the past few years, my uncle and grandfather and great grandmother all died from it, etc. I have not yet had a colonoscopy and despite my family history have no been able to get one scheduled until this year, when I turn forty. Isn’t that absurd? So, first of all, CONGRATULATIONS, you are doing the single most effective thing you can do to prevent colon cancer, years ahead of most people with strong risk factors. But also, again, you are already doing the most effective thing you can do. You probably have all this anxious energy and no where to put it while you wait.
My recommendation to you is to first try your absolutely damnedest to stop looking in the toilet bowl. If you fail at first that’s okay, just try again next time. Invest in a peri bottle to help keep yourself clean with much less irritation from lots of toilet paper friction if you don’t have a bidet already. If you have an external fissure or hemorrhoid flushing it with water will help it heal, too. I love using mine when I’m menstruating. It’s marketed as a portable thing but I just keep mine next to my tub for easy filling at home. Other than being gentle to your butt like this try to avoid ruminating on the area or anything that comes out of it. I know that’s difficult! But keep trying to redirect yourself.
My second suggestion is to get some physical activity. Depending on what you’ve been doing lately, just increase or vary it a small amount. So if you are normally athletic and training for a marathon or whatever, try some different activities that use different movements so you are engaging more of your mind and body in them, like martial arts or tennis. And if you’re like me a complete couch potato, try leaving some small weights around where you hang out, or dance in your kitchen, or go for a walk one day and do half an hour of yoga the next. Anything to take that anxious energy and use it up! Added benefits of this are that increased activity helps constipation and can be part of maintaining regularity of bowel movements. When I’m especially freaking out, a series of standing jacks, bodyweight squats, and fast paced sun salutations can really help me. It takes all that freakout juice and pushes it out through my breathing and sweat. Try to find your own thing that is super low barrier for you, so probably nothing that requires special equipment or locations, that you can just start doing when you feel your anxiety filling your body.
Good luck! You can get through this time period and you are doing exactly the right thing for now.
posted by Mizu at 8:05 AM on January 21 [4 favorites]
There’s a 10-15% false positive rate for iFOBT, and the results can be off because of any number of things (like what you ate in the days running up to the test). That’s why actual colonoscopy is still the gold standard test for colorectal cancer. The home kits are generally only recommended if there’s some reason you can’t do prep for a colonoscopy or can’t get to a facility to do a colonoscopy.
I would 100% not worry about the results of the iFOBT - but as a fellow sufferer of health anxiety, I know that’s easier said than done. You’ll know in a week if you have any issues. Until then, I would suggest a lorazepam or something similar to break the anxiety cycle and then distract, distract, distract yourself. That’s the only thing that works for mine.
posted by invincible summer at 4:38 PM on January 21
I would 100% not worry about the results of the iFOBT - but as a fellow sufferer of health anxiety, I know that’s easier said than done. You’ll know in a week if you have any issues. Until then, I would suggest a lorazepam or something similar to break the anxiety cycle and then distract, distract, distract yourself. That’s the only thing that works for mine.
posted by invincible summer at 4:38 PM on January 21
agree with everyone, but also, don't ignore the fact that you "recently went off Mounjaro." Mounjaro can do very bizarre things to all aspects of your g.i. tract! Going of it can change all kinds of things in the intestines/colon. also my gastroenterologist said that "pencil stools" can results from the pushing that you do when you're constipated. So add those to the doxycycline and you have good explanations for your symptoms. The colonoscopy results are going to make you feel MUCH better!
posted by DMelanogaster at 10:10 PM on January 21
posted by DMelanogaster at 10:10 PM on January 21
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Sometimes you just poop weird. It's almost always okay.
Eat some healthy bulky fiber and put on some chill tv. You've only got a week left until you're with a doc.
posted by phunniemee at 5:59 AM on January 21 [15 favorites]